ATTACHMENT A - CDRLS.pdf

B1475 D&D CONTRAT DATA REQUIREMENTS LIST (CDRL)

TABLE OF CONTENTS

CONTRACT/PR N0: XXXXX-XX-X-XXXX

Rev B. Dated 4-5-17

ITEM SUBTITLE

A001 LIST OF PERSONNEL

A002 RADIOLOGICAL PERSONNEL LISTING

A003 DISPOSAL INFORMATION

A004 RADIOLOGICAL SURVEYS

A005 RADIOLOGICAL TRAINING PLAN

A006 SUBCONTRACTORS

A007 CONTRACTS FUNDS STATUS REPORT

B1475 D&D CONTRACT DATA REQUIREMENTS LIST (CDRL)

CONTRACT/PR N0. XXXXXXXXXXXX-XX

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No.

listed in Block E.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER MGMT

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A001

2. TITLE OF DATA ITEM

CONTRACTOR’S PERSONNEL ROSTER

3. SUBTITLE

LIST OF PERSONNEL

4. AUTHORITY (Data Acquisition Doc. No)

D1-MGMT-81834A

5. CONTRACT REFERENCE

SECTION 4 SOW PARA 4.1

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D (SEE BLK 16)

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

(SEE BLK 16)

8. APP CODE

A

(SEE BLK 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

ADDRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 8: DRAFT TO BE PROVIDED VIA FORMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL

SHIPYARD, PORTSMOUTH, VA.

BLKS 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A COMPLETE

LIST OF ALL PERSONNEL, WITH SECURITY CLEARANCE. REVISIONS PROVIDED AS

CHANGES OCCUR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

NNSY C410: TBD (EMAIL ONLY)

NNSY C105: TBD (EMAIL ONLY)

NNSY C2300 0 1 0

NNSY C410 0 1 0

NNSY C105 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY

Mark Anderson

H. DATE

08/20/2020

I. APPROVED BY

J. DATE

17. PRICE

GROUP

18. ESTIMATED

TOTAL PRICE

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER MGMT

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A002

2. TITLE OF DATA ITEM

PROJECT PLANNING CHART

3. SUBTITLE

RADIOLOGICAL PERSONNEL LISTING

4. AUTHORITY (Data Acquisition Doc. No)

DI-MGMT-81834A

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.3.5

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

ONE/R

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

(SEE BLK 16)

8. APP CODE

A

SUBMISSION

ASREQ

ADDRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 8: DRAFT TO BE PROVIDED VIA FORMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK

NAVAL SHIPYARD, PORTSMOUTH, VA.

BLKS 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A COMPLETE

LIST OF ALL PERSONNEL. REVISION PROVIDED AS CHANGES OCCUR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POINT OF CONTACT LIST FOR RADIOLOGICAL PERSONNEL TO INCLUDE THE

FOLLOWING: RADIOLOGICAL CONTROL DEPARTMENT, RADIOLOGIAL WASTE

MANAGEMENT, RADIATION WORKER TRAINING, AND RADIOACTIVE MATERIAL

CONTROL OFFICE.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

15. TOTAL 3

Mark Anderson

H. DATE

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER MGMT

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A0003

2. TITLE OF DATA ITEM

HAZARDOUS WASTE REPORT

3. SUBTITLE

DISPOSAL INFORMATION

4. AUTHORITY (Data Acquisition Doc. No)

DI-MGMT-82129

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.5 & 7.6

(SEE BLK 16)

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

ASGEN

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

(SEE BLK 16)

8. APP CODE

A

SUBMISSION

ASREQ

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 5: CONTENT SHALL BE IN ACCORDANCE WITH SECTION 7 SOW PARA 7.5.5, 7.5.6,

7.5.10, 7.6.4, 7.6.5, 7.6.6, AND 7.6.9.3.

DISPOSAL INFORMATION (EITHER WASTE EVALUATION FORM OR TECHNICAL WORK

DOCUMENT) FOR REVIEW AND APPROVAL PRIOR TO TRANSFER OF ANY WASTE TO

NNSY THIS WILL INCLUDE CHARACTERIZATION INFORMATION AND ALL INFORMATION

REQUIRED PER STEP 7.5.5 OF THE SOW. THIS INCLUDES:

a. INFORMATION USED TO SERIALIZE THE CONTAINER (e.g. SERIAL NUMBERS, TRACKING, ETC.).

b. CONTAINER WEIGHT (RECORDED IN LBS).

c. ALL APPLICABLE SURVEYS (RECORDED IN mR/hr).

d. INVENTORY LIST FOR EACH CONTAINER TURNED OVER TO NNSY.

e. IF REQUIRED, PROOF ITEM(S) ARE BLOCKED AND BRACED SATISFACTORY PER

REFERENCE 5.11.

f. ALL APPLICABLE NNSY DOCUMENTATION (APPENDIX Ns FOR ORW WASTE, TWDs, ETC.).

g. PROOF OF SATISFACTORY CLOSURE PER MANUFACTURE’S CLOSURE

INSTRUCTIONS.

BLK 8: DRAFT TO BE PROVIDED VIA FORMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE DEPARTMENT

OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI) (13July2016). OTHER

REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL SHIPYARD, PORTSMOUTH,

VA.

BLK 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A CONDITION REPORT

OF THE FINDINGS AS THEY BECOME AVAILABLE OR AS AGREED TO BETWEEN THE

GOVERNMENT AND THE CONTRACTOR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

15. TOTAL 0 3 0

Mark Anderson

H. DATE

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

C. CATEGORY

TDP TM OTHER MISC

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A004

2. TITLE OF DATA ITEM

CERTIFICATION /DATA REPORT

3. SUBTITLE

RADIOLOGICAL SURVEYS

4. AUTHORITY (Data Acquisition Doc. No)

DI-MISC- 80678 (SEE BLK 16)

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.7.1 & 7.9.1.2

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

N/A

ASGEN

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

(SEE BLK 16)

8. APP CODE

A

SUBMISSION

ASREQ

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 4: THE CONTRACTOR SHALL PROVIDE RADIOLOGICAL SURVEY RESULTS IN A

FORMAT ACCEPTABLE PER RADIOLOGICAL CONTROLS FOR SHIPYARDS (NAVSEA

389-0288). NOTE: SECTION 10.2.2 DOES NOT APPLY TO THIS DATA ITEM

DESCRIPTION.

BLK 8: DRAFT TO BE PROVIDED VIA FORMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL

SHIPYARD, PORTSMOUTH, VA.

BLK 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A CONDITION

REPORT OF THE FINDINGS AS THEY BECOME AVAILABLE OR AS AGREED TO

BETWEEN THE GOVERNMENT AND THE CONTRACTOR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

Mark Anderson

H. DATE

Form Approved

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

C. CATEGORY

TDP TM OTHER MISC

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A005

2. TITLE OF DATA ITEM

CERTIFICATION. DATA REPORT

3. SUBTITLE

RADIOLOGICAL TRAINING PLAN

4. AUTHORITY (Data Acquisition Doc. No)

DI-MGMT-80678

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.11.3.1, 7.11.3.1.2,

7.11.3.6

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

ONE/R

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

SEE BLK 16

8. APP CODE

A

SUBMISSION

ASREQ

ADDRESSEES Draf t

Final

Reg Repr o

16. REMARKS

BLK 8: DRAFT TO BE PROVIDED VIA FORMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL

SHIPYARD, PORTSMOUTH, VA.

BLKS 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A CONDITION

REPORT OF THE FINDINGS AS THEY BECOME AVAILABLE OR AS AGREED TO

BETWEEN THE GOVERNMENT AND THE CONTRACTOR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL IN A

DOWNLOADABLE MICROSOFT OFFICE ACCEPTABLE FORMAT THAT WILL BE WRITE-

PROTECTED. THE CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT

ORGANIZATIONAL ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

Mark Anderson

H. DATE

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

C. CATEGORY

TDP TM OTHER MGMT

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A006

2. TITLE OF DATA ITEM

LIST OF SUBCONTRACTORS REPORT

3. SUBTITLE

SUBCONTRACTORS

4. AUTHORITY (Data Acquisition Doc. No)

DI-MGMT-82070

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.13.1

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

ONE/R

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

SEE BLK 16

8. APP CODE

A

SUBMISSION

ASREQ

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 8: DRAFT TO BE PROVIDED VIA FROMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL

SHIPYARD, PORTSMOUTH, VA.

BLK 10, 12 & 13: THE CONTRACTOR SHALL PREPARE AND SUBMIT A CONDITION

REPORT OF THE FINDINGS AS THEY BECOME AVAILABLE OR AS AGREED TO

BETWEEN THE GOVERNMENT AND THE CONTRACTOR.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

15. TOTAL 2

Mark Anderson

H. DATE

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

C. CATEGORY

TDP TM OTHER FNCL

D. SYSTEM/ITEM

B1475 D&D

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO

A007

2. TITLE OF DATA ITEM

CONTRACT COST REPORT FOR AVAILS GREATER

THAN 12 WEEKS

3. SUBTITLE

CONTRACT FUNDS STATUS REPORT

4. AUTHORITY (Data Acquisition Doc. No)

DI-FNCL-81788

5. CONTRACT REFERENCE

SECTION 7 SOW PARA 7.2.5

6. REQUIRING OFFICE

NNSY C2300

7. DD 250 REQ

DD

MTHLY

12. DATE OF FIRST SUBMISSION

30DAC

14. DISTRIBUTION

SEE BLK 16

8. APP CODE

A

SEE BLK 16

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 4: TAILOR DID AS FOLLOWS: REPORTING FOR FORMAT 1 SHALL BE AT THE

CLIN LEVEL.

BLK 8: DRAFT TO BE PROVIDED VIA FROMAL CORRESPONDENCE. APPROVAL BY

GOVERNMENT TO BE 10 WORKING DAYS AFTER RECEIPT.

BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY (CARRIER UNNPI)

(13July2016). OTHER REQUESTS SHALL BE REFERRED TO POC AT NORFOLK NAVAL

SHIPYARD, PORTSMOUTH, VA.

BLK 11 & 13: SUBMISSION SHALL CONTINUE ON A MONTHLY BASIS UNTIL DATA IS

REFLECTED FOR 30 DAYS AFTER THE PERIOD OF PERFORMANCE.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL. THE

CONTRACTOR SHALL NOTIFY THE APPROPRIATE GOVERNMENT ORGANIZATIONAL

ENTITIES BY EMAIL WHEN REPORT IS POSTED.

POCs:

NNSY C2300: TBD (EMAIL ONLY)

NNSY C1200: TBD (EMAIL ONLY)

NNSY C1200N: TBD (EMAIL ONLY)

NNSY C1200 0 1 0

NNSY C1200N 0 1 0

15. TOTAL 4

Mark Anderson

H. DATE